Some say that they are an extension of the Gods above. Through their deeds, countless young and bright minds are welcomed to the world, desperate souls can see brighter days, and some civilizations can thrive to see up to more than a century.
Praises are often sung for them, especially those who saved others in exchange for their lives.
With such power in their hands, surely, they would be seen in a light so good that it is blinding. Yet, as people say, there is the darkest shadow cast for every brightest light.
In their noble service, medical professionals are often treated as lesser beings or even worse. It seems as though the many years of rigorous study and practice are not sufficient challenges for doctors.
The seventh president, Joko Widodo, pointed out that Indonesia lacks physicians and specialists doctors, with the ratio being only 0.47 for 1000 people.
It appears that meeting the needs of the 1:1000 ratio became harder, for medical professionals often face harsh treatment and violent situations at every step of the way.
Series of eye-openers
In August 2024, Indonesia was shaken by the news of the death of AR, a medical specialist student from Diponegoro University studying anesthesiology at Semarang's Kariadi Hospital. Her body was found in her dorm room, and the cause of death was the injection of certain substances.
Bullying and inhumane workload were speculated to be the factors that drove AR to her demise. Nonetheless, it was disputed by the university that cited AR's health issues as the cause.
Numerous pieces of evidence disputed this claim, from the student's personal diary expressing her academic struggles and a detailed record of her financial transactions from the beginning of her studies until just before her death.
To follow up with the suspicion of bullying as reported by the family of the deceased, the Central Java Police investigated dozens of AR's classmates. As for the fees that AR had to pay, her mother, Nuzmatun Malina, noted that in the earlier semesters, the fees that her daughter had to pay for the students' collective fund were larger.
AR family's attorney, Misyal Achmad, said she had to pay a total fee of Rp225 million during her study.
According to the Health Ministry's Spokesperson Mohammad Syahril, investigations uncovered that AR was allegedly required to make monthly payments of Rp20-40 million to senior students apart from the program's official fee.
Eventually, about a month after the case garnered widespread national attention, the university and hospital acknowledged the presence of bullying within the program. Dean of Undip's Faculty of Medicine, Yan Wisnu, tendered a public apology over that fact and was later temporarily relieved of his duties as an oncologist at Kariadi Hospital.
AR's case of alleged bullying was just the tip of the iceberg. On August 19, the Health Ministry reported having received 356 reports of cases of bullying, 211 of which took place in the ministry's hospitals.
However, that was not the end of it, as apart from bullying, medical professionals are at risk of being assaulted.
On November 5, at around 13:35 local time, someone, allegedly a local official, barged into the Lukas Enembe Regional Hospital, vociferously making a demand, and after that, headed to Dr Yordan Sumomba's room, grabbed a chair, and flung it at the doctor but it narrowly missed him.
The perpetrator then seized a log and struck the doctor's face and back. Witnessing this altercation, a patient currently undergoing treatment attempted to intervene but was also attacked by the perpetrator.
Following the attack, the perpetrator vandalized a wooden partition, seized a rock, and smashed a window at the hospital before leaving.
The doctor, Sumomba, sustained severe injuries, including a broken right cheekbone, nose, and facial fractures, as well as extensive bruising on his back. The severity of his injuries necessitated his transfer to Makassar's Wahidin Sudirohusodo Hospital for further treatment.
Head of Jayawijaya's National Medical Association (IDI), Dr Lorina, stated that Sumomba is a contracted doctor determined to serve the Papuan region wholeheartedly.
They expected this incident would elicit action from the government, given that several doctors in Papua often face threats of verbal and physical conflicts.
"The number of physicians and specialists who want to work in Papua and Papua Highlands keep declining each year because of conflict and absence of guarantee of security and safety. Moreover, the incentive received is not proportional to the high cost of living in Papua, particularly in the Highlands," Lorina noted.
Health Ministry's head of communication and public services, Aji Muhawarman, noted that the ministry regretted the incident and stated that the perpetrator had been apprehended and would undergo further legal proceedings. Moreover, the regional hospital was operational again after the police handled the situation.
"Health personnel and medical personnel supposedly received a guarantee of security and safety in providing health services," Muhawarman remarked.
After the wake-up calls
Head of IDI Adib Khumaidi remarked on the 2024 National Health Day that some national health issues include the lack of appreciation for doctors in the form of guarantee of their safety, security, and welfare through incentives, particularly for those working in remote areas.
Khumaidi expected those challenges to be met through collaborative efforts, particularly from the central and regional governments.
On the other hand, the Health Ministry has also made some major changes to prevent and handle bullying in specialist doctor programs.
Health Ministry's Inspector General Murti Utami stated that several steps that should be taken comprised revising the ministerial instruction and revamping medical faculties' and hospitals' management.
She noted that bullying occurred due to the lack of monitoring and transparency. Hence, the ministry eventually issued a policy to register all communication channels of specialist programs on messenger platforms, such as WhatsApp and Telegram, with the hospital.
The ministry stated that the channels must include the head of the department as a representative from the hospital, as well as the head of the study major as the university's representative.
They have also laid out some punishments in the event of being found on unofficial communication channels or if bullying occurred on the official channel.
Moreover, they have been taking action to resolve the cases, such as putting a temporary stop to Manado's Kandou Central Hospital and Sam Ratulangi Faculty of Medicine's internist program.
Director General of Health Services Azhar Jaya stated that the step was taken to give time for both institutions to apply proper preventive measures to avoid more victims falling to it, given that the ministry found verbal and non-verbal bullying in the program, and the seniors were imposing illegal levies.
He also pointed out that the seniors and supervisors of the program believed that bullying in medical study programs is normal and common practice in similar programs.
The need for a healthy and safe environment for doctors to be productive underscores the urgent requirement for changing the system to prevent the health sector from collapsing. Human resources, after all, constitute a major chunk of what makes it whole.
Related news: Ministry, police to jointly investigate PPDS doctor suicide case
Related news: Papua needs more specialists to improve health services: official
Editor: Rahmad Nasution
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